260241 (SFD)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
1 ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
SQ.FT., @
UNITS
SO. FT. @
SQ. FT. @
SQ. FT. @
MOBILEHOME SVC. '
POWER OUTLET'
SQ.F1. @
DRAINAGE PIPING
SO. FT. @
DRINKING FOUNTAIN
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
URINAL
NOTE: Not to be used as property tax Voluation
SWIM POOL, PVT
MECHANICAL FEES
SWIM POOL, COMM
SUPP. TO PERMIT
VENT SYSTEM O FAN ❑ EVAP. COOL ❑ HOOD
I.SIGN
FIELD OFFICE
NO. PLUMBING FEES
DST/
�!
OWNER
74
YARD SPKLR SYSTEM
BAR SINK
USE OF PERMIT �,.,_.a, ,-
�c�3GG'./"¢_-' 4�i-
ROOF DRAINS
DATEPERMIT
1_.7S
DRAINAGE PIPING
M H PERMIT FEE
DRINKING FOUNTAIN
$
URINAL
COMMUNIT
WATER PIPING
UNITS ircoms
FLOOR DRAIN
SUPP. TO PERMIT
WATER SOFTENER
WASHFR IAI ITOI MISH1
APPLIANCE
JOB ADDRESS. SP NO
OWNER
74
GARBAGE DISPOSAL
FURNACE O UNIT O WALL O FLOOR O SUSPENDED
USE OF PERMIT �,.,_.a, ,-
�c�3GG'./"¢_-' 4�i-
F.C.
DATEPERMIT
1_.7S
LAUNDRY TRAY
M H PERMIT FEE
AIR HANDLING UNIT CFM
$
IDLE METER
COMMUNIT
KITCHEN SINK
UNITS ircoms
ABSORPTION SYSTEM 0 B.T.U.
SUPP. TO PERMIT
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR HP
Y�
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM O FORCED O GRAVITY _
MICROFILM FEE
AMPERES SERV ENT
$
SHOWER
LEGAL DESCRIPTION
BOILER � B.TM.
SQ FT @ ¢
BATH TUB
MECHANICAL FEE
i
6_
$ /
SQ FT @ C
SEETBBA•C,K
WATER HEATER
/
USE NO_
GRP
SQ FT RESID @ - 1 ¢
ICK BjY,+j
,f '�' `•
SEWAGE DISPOSAL
PLAN CHECK FEE
$
SQ FT GARAGE @ '/ra
BOND AMT.
HOUSESEWER
PLAN CHECKER
PERMIT FEE
GAS PIPING
MOBILE HOME PERMIT FEE $
PERMIT FEE
PERMIT FEE
PERMIT NO. -
260241
TOTAL FEES
/oma ��
MOB. HM.FEE
MICRO FEE
MECH. FE
�„ ?�=
:riBC
PL. CK. FEE
CONST. FEF„DBL:
�
oz/5Yz
ELECT. FEE -Y38C.
SMI FEE
FEE
PLUMB. FEE
24 =
$
J I F I M A I M I J I 1 I A I S •.j O N I- D
JOB ADDRESS. SP NO
OWNER
74
75
76
USE OF PERMIT �,.,_.a, ,-
�c�3GG'./"¢_-' 4�i-
F.C.
DATEPERMIT
1_.7S
NO.
260241
M H PERMIT FEE
$
COMMUNIT
SST
UNITS ircoms
VALUATION
SUPP. TO PERMIT
OFFICE
Y�
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
i
6_
$ /
+f�
SEETBBA•C,K
LOT SIZE ZONE
;
/
USE NO_
GRP
[TYPE
ICK BjY,+j
,f '�' `•
)
F_:7 '.C./ S R/ CEJ
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
JINSPECTOR
I 6 -.;,q ? J
CONSTRUCTION FEE
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOL D
f +
ELECTRICAL FEE
$
ADDRESS CITY
STATE
•
/�
�•�
lift
a f
s4 i I' '
STRONG MOTION -
$
OWNER/AGENT'S StG : /
CONTRACTOR
INSTRUMENTATION FEE
-
$
A DRESS
ADDRESS
FEE
/
PLUMBING FEE
=7,
$
CJ1
CITY ZIP CODE
CITY ZIP CODE
SCJ
yrCr
fL�Li j t E Get f C_`' A
TOTAL FEES �
C
4:..•�
TEL. NO.
� �
��� -M�_ ..�.,�.�G.`1/
CASH ❑. CHECK M.O. O N.C. ❑
THIS PERMIT SHALL BECOME V61D IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
ION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. .
RECEIVED BYr{ j
TREES REQUIRED
I HEREBY AGREE THAT -ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, -I ALSC
SEWAGE SYSTEM'
T
LL
p
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
- lC ECTATC —i-ni JE -11A —1—KIr —ITnAi-T—C is IA]—riiAnAA1TC-
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.